Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11067 | Date 25/01/2024 |
| Token No | SM/22-23/14407 25/01/2024 | Serial | 005 |
| Patient Name | Mrs. ASNARA BIBI | Contact No | NOT GIVEN |
| Address | AKC BHATTACHARYA STREET | Age | 21 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||